Intra-operative assessment of the vascularisation of a cross section of the meniscus using near-infrared fluorescence imaging

Schie, P. van; Lelij, T.J.N. van der; Gerritsen, M.; Meijer, R.P.J.; Arkel, E.R.A. van; Fiocco, M.; Swen, J.W.A.; Vahrmeijer, A.L.; Hazelbag, H.M.; Keereweer, S.; Driel, P.B.A.A. van

doi:doi:10.1007/s00167-021-06690-w

Persistent URL of this record https://hdl.handle.net/1887/3212832

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Medicine / Leiden University Medical Centre (LUMC)

Schie, P. van; Lelij, T.J.N. van der; Gerritsen, M.; Meijer, R.P.J.; Arkel, E.R.A. van; Fiocco, M.; ... ; Driel, P.B.A.A. van (2021)

Intra-operative assessment of the vascularisation of a cross section of the meniscus using near-infrared fluorescence imaging

Article / Letter to editor

Purpose The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra-operatively using near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA). Methods The anterior horn (i.e., Cooper classification: zones C and D) of the meniscus that was least affected (i.e., least degenerative) was removed during TKA surgery in ten patients to obtain a cross section of the inside of the meniscus. Thereafter, 10 mg of ICG was injected intravenously, and vascularisation of the cross section of the meniscus was assessed using the Quest spectrum NIRF camera system. We calculated the percentage of patients in whom vascularisation was observed intra-operatively using NIRF imaging compared to immunohistochemistry. Results Meniscal vascularisation using NIRF imaging was observed in six out of eight (75%) patients in whom vascularisation was demonstrated with immunohistochemistry. The...Show morePurpose The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra-operatively using near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA). Methods The anterior horn (i.e., Cooper classification: zones C and D) of the meniscus that was least affected (i.e., least degenerative) was removed during TKA surgery in ten patients to obtain a cross section of the inside of the meniscus. Thereafter, 10 mg of ICG was injected intravenously, and vascularisation of the cross section of the meniscus was assessed using the Quest spectrum NIRF camera system. We calculated the percentage of patients in whom vascularisation was observed intra-operatively using NIRF imaging compared to immunohistochemistry. Results Meniscal vascularisation using NIRF imaging was observed in six out of eight (75%) patients in whom vascularisation was demonstrated with immunohistochemistry. The median extent of vascularisation was 13% (interquartile range (IQR) 3-28%) using NIRF imaging and 15% (IQR 11-23%) using immunohistochemistry. Conclusion This study shows the potential of NIRF imaging to visualise vascularisation of the meniscus, as vascularisation was observed in six out of eight patients with histologically proven meniscal vascularisation.Show less

Meniscal vascularisation

Near-infrared fluorescence imaging

Indocyanine green

Intraoperative imaging

Total Knee Arthroplasty